While antipsychotics are rarely fatal when taken alone, overdose can present some unique management problems. With the exception of thioridazine (Mellaril), antipsychotics are potent antiemetics. The antiemetic effect may interfere with pharmacologic induction of emesis, and gastric lavage is often required. Agents with beta-agonist activity such as isoproterenol are contraindicated for cardiovascular support because beta-stimulated vasodilatation may worsen hypotension. Extrapyramidal effects may also be prominent in antipsychotic overdosage and are best treated with 50 to 100 mg IV of diphenhydramine (Benadryl).
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